Austral University Hospital, Buenos Aires, Argentina; Universidad de Buenos Aires (UBA), Argentina; Austral University, Buenos Aires, Argentina.
Foot Ankle Surg. 2021 Oct;27(7):742-749. doi: 10.1016/j.fas.2020.09.010. Epub 2020 Sep 29.
Ankle fractures are the most common traumatic bone injuries of the lower limb. Over 50% of ankle fractures occur at the syndesmosis level (type AO B). The goal of treatment is to achieve an anatomical reduction and appropriate stabilization. The present study aimed to evaluate the clinical-functional and radiological results, and complications of minimally invasive reduction and fixation technique for ankle fractures type AO B. The surgical technique also is detailed.
A prospective analysis of 451 patients undergoing surgery for type AO B displaced ankle fracture was performed. All patients were treated with minimally invasive surgery. The following times were recorded: time between trauma and osteosynthesis, hospitalization length, surgical time, and exposure time to fluoroscopy. Age and gender, mechanism of injury, and characteristics of fractures were recorded. For functional outcome, AOFAS score, VAS, and Weber score were used. Radiographic analysis was performed. The average follow-up was 112 months.
Mean age was 48.2 years old. Average length of stay in hospital was 5.72 h. Mean duration of the surgery was 32.8 min. Average fluoroscopic exposure time during surgery was 9.25 s. Mean bone union time was 38.2 days. Weber's score was on average 1.5/24 points and the long-term follow-up AOFAS score was on average 97.5/100. Postoperative complications incidence was 2.7%.
Distal fibula fixation with the MIPO technique presented good functional outcomes and could be helpful in the avoidance of the complications associated with conventional open reduction and internal fixation. However, it needs more exposition to intraoperative fluoroscopy.
II.
踝关节骨折是下肢最常见的外伤性骨损伤。超过 50%的踝关节骨折发生在联合水平（AO 分型 B 型）。治疗的目的是实现解剖复位和适当的固定。本研究旨在评估微创复位固定技术治疗 AO 分型 B 型踝关节骨折的临床-功能和影像学结果及并发症。手术技术也做了详细介绍。
对 451 例行 AO 分型 B 型移位踝关节骨折手术的患者进行前瞻性分析。所有患者均采用微创外科手术治疗。记录以下时间：创伤与骨合成之间的时间、住院时间、手术时间和透视暴露时间。记录年龄和性别、损伤机制和骨折特征。采用 AOFAS 评分、VAS 和 Weber 评分评估功能结果。进行影像学分析。平均随访时间为 112 个月。
平均年龄为 48.2 岁。平均住院时间为 5.72 小时。平均手术时间为 32.8 分钟。术中透视平均暴露时间为 9.25 秒。平均骨愈合时间为 38.2 天。Weber 评分平均为 1.5/24 分，长期随访 AOFAS 评分为平均 97.5/100 分。术后并发症发生率为 2.7%。
采用 MIPO 技术固定腓骨远端可获得良好的功能结果，并有助于避免传统切开复位内固定相关并发症。但需要更多的术中透视暴露。
II 级。
